If you want to bear witness to one of the most dismal policy and political debacles in American history, consider the last five American presidents and the last dozen or so congresses when it comes to health care.

In managing one-sixth of the nation’s economy and the needs of the populace, this is simply a sad story, sans leadership.

I will give some examples via my own personal prism. Last summer I was at my cabin, got tangled up in my dog’s tether and split my forehead open. A friend drove me to Columbus Regional Hospital emergency room where in 90 minutes I received 24 stitches and a tetanus shot.

The bill: $1,600.

My friend Mike Carr, a health consultant who helped Gov. Mitch Daniels devise the welfare “hybrid plan,” observed, “That comes out to over $1,000 an hour.”

It underscores a Rand Corp. analysis of Indiana hospital costs, which it terms “shockingly high” for charges of in-patient and out-patient procedures, often three times that of other markets.

I’m on an IU Health insurance silver plan, so the $5,000 deductible didn’t help. Since Obamacare was passed in 2010, I’ve been on MDWise, Anthem and IU Health plans. The latter two are pulling out of the Indiana Obamacare exchange, so I’ll be on my fourth insurer next January. My monthly premiums (for just me) have gone from $440, to $780 and $681 this year. I expect them to skyrocket next year.

President George H.W. Bush scuttled the catastrophic health plan forged under Doc Bowen and President Reagan. President Bill Clinton and Hillary Clinton couldn’t pass health reforms in 1993. President George W. Bush and Republicans ignored the skyrocketing costs and lack of coverage for those of us with pre-existing conditions, despite controlling the White House and Congress for six years.

President Barack Obama passed the Affordable Care Act, which has not been affordable. Republicans dug in and refused for seven years to evolve Obamacare.

And throughout the spring, summer and fall of this year, President Donald Trump and the Republican congressional majorities have been punking us with repeal and replace schemes that would throw tens of millions of Americans off insurance rolls, including some 420,000 Hoosiers on the Healthy Indiana Plan 2.0, and jack up premiums. A Kaiser Family Foundation analysis of the current Graham/Cassidy joke reveals Indiana will lose about $1.5 billion in federal Medicaid funding between 2020 and 2026.

Remember when Gov. Eric Holcomb and General Assembly Republicans passed the gas and diesel tax increase last winter to fund our roads? Quietly in the 11th hour, they slipped in an amendment that would allow them to shift fuel tax dollars to prop up health programs like HIP 2.0 if Trump and Congress somehow foist the Graham/Cassidy joke into law.

We’ve watched Trump act as if he doesn’t understand the Republican health bills. He simply wants a “deal” and a “victory” even if it turns his 2016 campaign vows of affordable and “great” health care “for everyone” on their head.

Wednesday he tweeted, “I would not sign Graham-Cassidy if it did not include coverage of pre-existing conditions. It does! A great Bill. Repeal & Replace.”

But the bill as it stands at this writing gives states the option of waiving pre-existing condition standards.

Avalere Health, a nonpartisan consulting firm, told the news site Axios the Graham/Cassidy bill would cut $215 billion in federal spending by 2026, growing to more than $4 trillion after its block grants cease to exist. AARP, which opposes the bill, released a report saying premiums for older consumers could rise by roughly $16,000 per year.

The Los Angeles Times reports, “The latest Republican bid to roll back the Affordable Care Act would likely leave millions of currently insured Americans without health coverage in the coming decades.”

“If you have less money, you either cover fewer people, or you cover the same amount of people with less generous coverage,” Avalere’s Caroline Pearson told Axios. “So if a bill reduces the availability of comprehensive insurance, people with chronic conditions are going to be disproportionately harmed.”

The Senate bill up for a vote this week won’t come with any public hearings, no amendments and won’t have a Congressional Budget Office scoring. U.S. Sen. Lisa Murkowski, who could scuttle this joke, said, “The problem last time was process and substance. Nobody knew what we were really ... voting on.”

It’s the same way on this bill. U.S. Sen. John McCain, who killed the last GOP bill, added, “Nothing has changed. I am the same as I was before. I want the regular order.” By regular order, he means a bipartisan process with hearings and amendments.

The best idea floated by Republican state Sen. John Ruckleshaus — an independent, bipartisan commission to study and make recommendations — is a no-brainer but nonstarter in an inert U.S. Capitol and White House.

Brian Howey is publisher of Howey Politics Indiana. Follow him on Twitter @hwypol. The opinions are the writer's.

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